Analytical Review of Complex Regional Pain Syndrome for Clinicians

Vol. 10 | Issue 2 | August-September 2022 | Page: 36-39 | Kishore Vellingiri, Anil K Bhat, Ashwath M Acharya, Mithun Pai G


Authors: Kishore Vellingiri [1], Anil K Bhat [1], Ashwath M Acharya [1], Mithun Pai G [1]

[1] Department of Hand Surgery, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.

Address of Correspondence

Dr. Anil K. Bhat,
Associate Dean, Professor and Head Department of Hand Surgery, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.



A painful and incapacitating condition known as complex regional pain syndrome (CRPS) can develop following a stroke, an injury to the limbs, or occasionally even without any known precipitating event. There are two categories for CRPS: Patients with CRPS-I do not have a verified nerve injury, but those with CRPS-II have linked nerve damage. Different physiopathology can cause CRPS. Both peripheral and central mechanisms, including neuroplastic changes like cortical reorganization, altered afferent-efferent feedback, and central autonomic dysregulation, have been observed. Peripheral mechanisms include inflammation, peripheral sensitization, and sympatho-afferent coupling. Patients with CRPS types 1 and 2 may experience clinical symptoms and their severity in this situation differently. The Budapest Criteria stipulates that a patient must exhibit at least one symptom in two or more of the four categories of sensory, vasomotor, sudomotor/edema, and/or motor/trophic at the time of evaluation. Ketamine, memantine, intravenous immunoglobulin, epidural clonidine, intrathecal clonidine/baclofen/adenosine, aerobic exercise, mirror therapy, virtual body swapping, and dorsal root ganglion stimulation may all have therapeutic benefit. Experiments have also shown an increasing role for peripheral sympathetic nerve blocks, as well as lumbar/thoracic sympathetic, stellate ganglion, and brachial plexus blocks.
Keywords: Complex regional pain syndrome, Budapest, Ketamine, Vitamin C


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How to Cite this article:  Vellingiri K, Bhat AK, Acharya AM, Pai GM |  Analytical Review of Complex Regional Pain Syndrome for Clinicians | Journal of Karnataka Orthopaedic Association | August-September 2022; 10(2): 36-39.


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